Surgical procedures for accessing tissue located deep within the body can pose a risk of trauma to the intervening tissue, particularly when the tissue includes neural tissue. During a surgical procedure where access to the spine is required, the final layers of tissue, those most proximate to the spine, are densely populated with large nerve fibers. Since the tissue is nerve-dense, the surgeon must take the greatest care when manipulating the tissue as the deep nerve fibers are remote from the surgeon, follow only general anatomic patterns, and are beneath, within, or above sensitive layers of tissue.
Various configurations of access devices have been developed to gain and maintain access to surgical fields, such as the spinal column, through deep access portals in tissue. For example, Penfield devices have been used in surgical procedures to manipulate muscular and neural tissue. However, the use of a Penfield device requires extending the tip of the Penfield device deep into the access portal to the surgical field. As the Penfield device is disposed within the deep access cavity, the surgeon typically losses visual contact of tissue that is adjacent to the distal tip of the Penfield device. As the surgeon loses sight of the working area, often due to a lack of light in the deep access portal, the likelihood of inadvertent contact and damage of sensitive neural tissue increases.
Accordingly, there remains a need for improved methods and devices for safely performing the surgical retraction of tissue.